Chapter 1: What is Judge Milton Mack's mission for mental health reform?
Happy holidays. Want to give your host a gift? Consider subscribing, rating, and reviewing the show this holiday season. It really helps the show grow. From all of us at Believe, have a Merry Christmas, everyone, and a happy holiday. Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide. Hosted by Tony Miator. Broadcasting from the heart of Music City, USA, Nashville, Tennessee.
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Tune in, be inspired, and join us in transforming the world one story at a time. you Hi, I'm Tony Mantor. Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide. We're taking a brief holiday break, so we'd like to wish you a Merry Christmas and Happy Holidays. We also want to take the time to share one of our favorite episodes from the past six months for you to enjoy.
So before we dive into our episode, we'll be back with an uninterrupted show right after a word from our sponsors. Today, we're thrilled to be joined by a truly remarkable guest, Judge Milton Mack.
Judge Mack brings a wealth of experience to the conversation, having served as the state court administrator for the Michigan Supreme Court and as chair of the Governor's Mental Health Diversion Council. He's also held the role of chief judge of the Wayne County Probate Court and worked as a consultant and advisor for numerous advocacy groups.
In 2017, his groundbreaking policy paper, Decriminalization of Mental Illness, Fixing a Broken System, played a pivotal role in the creation of the National Justice Task Force to examine state courts' response to mental illness. where he served as co-chair from 2019 to 2020. With his deep expertise and passion for reform, it's an absolute honor to have Judge Mack with us today.
Thanks for coming on. Well, it's been a passion of mine for some years now, so we're making progress. Yes, it's a great passion. Can you tell us why it became a passion of yours?
Well, when I became a probate judge, that's when I started hearing these mental health cases, and I had no familiarity with them at all. But it did take me long to say, I don't think this is working. I'm seeing the same people over and over and over again.
This person's been hospitalized by every probate judge who's served since 1970, and with multiple hospitalizations, and it just seemed to me that things weren't working. We weren't accomplishing anything, that we were just in this revolving door. I started to agitate for change, you might say. This led to my being appointed to the Governor's Mental Health Commission in 2004.
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Chapter 2: How does Michigan's mental health system emphasize early intervention?
Are you faced with decompensation, deterioration? And does this create a risk of harm? The harm doesn't have to be immediate. So, for example, we had a case in Michigan at the trial, the mental health trial. The doctor testified that the individual was not presently at risk of harm. However, he had a history of stopping taking his medicine.
And the doctor testified that he could be expected to stop taking his medicine in three to six months. And he would then be at risk of harm, harm in the form of drug abuse, suicide, increased risk for dementia, and so forth. And the court of appeals said, yeah, that's good enough. But how, looking at the total circumstance, would you get somebody into treatment?
What we've done in Michigan is we actually have a system of mediation for mental health cases, which I think is kind of unique. Works best for petitions where you ask for outpatient treatment only. So we have a system in Michigan now where you can file a petition with the probate court, don't go to the hospital, don't go to the police department. The person, let me put it this way.
When I'm hearing cases in probate court, and I'd ask family members, when did he stop taking his medication? And they say six months ago, eight months ago. We all know where this is going. We're just waiting for the magic moment. Well, no, we don't have to wait anymore. So you can file a petition with the probate court and get a hearing on whether to order outpatient treatment.
And then as an extra tool, instead of going to a full hearing, you can say, let's go to mediation. So we have mediation centers across the state. We have about 100 mediators who are trained in mental health issues to mediate these disputes. If you're going to mediate an agreement with someone who has a mental illness, you have engagement. You have the likelihood of compliance.
I have four bills pending in the legislature right now. They have passed the Senate around the floor of the House as we speak. I might get attempts any minute now from Senator Hurtado telling me we got them all done. The bills I had introduced expand mediation so that providers of care will have a better option. The providers of care don't like to petition their clients for treatment.
They'll certainly take advantage of mediation. They'll see if their client is beginning to decompensate. And before it gets too bad, it's going to get mediation. We are trying to make the process work better.
These all sound like they're great ideas that you've been able to accomplish. Have you had any bumps in the road in doing some of these things that you're trying to do?
So we still have some blockages. For example, if I want someone to get outpatient treatment only, I have to have a psychiatrist testify. If I want them to be hospitalized, a psychologist can testify. To me, it would seem that the higher-ranking medical person ought to be talking about hospitalization. and a lower echelon person talking about outpatient treatment.
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Chapter 3: What changes have been made to reduce hospitalization in mental health cases?
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From all of us at Believe, have a Merry Christmas, everyone, and a happy holiday. If you like the show, please take a moment to rate, review, and subscribe. It really does help the show to grow. Thank you for listening.